Exploring controversies and pathways forward in COVID-19 long-haul syndrome

Long-haul novel coronavirus (COVID-19) is the challenge we need to rise to and the challenge of our time, said David Brady, ND, DC, CCN, DACBN, IFMCP, FACN at the 2022 Integrative Healthcare Symposium in New York City. This is a topic that is evolving by the hour, not by the day. 

Brady, who is an associate professor at University of Bridgeport, and maintains a clinical practice in Fairfield, Connecticut, led a panel of integrative healthcare experts, including Bruce Patterson, MD, founder and chief executive of IncellDx; Richard Horowitz, MD, medical director of the Hudson Valley Healing Arts Center; Thomas Fabian, PhD, CNTP, educator and medical consultant at Diagnostic Solutions Laboratory; and Gez Medinger, a science journalist and patient advocate.

In Bergamo, Italy, Brady said, when people survived COVID-19 and left the hospital, doctors started noticing that these patients did not return to their original state of health. They started calling these patients back and monitoring their symptoms -fatigue, breathlessness, joint and chest pain, electrical feeling symptoms.

Once you have an acute viral infection and you recover from it, you are not necessarily in the clear, Brady said.

Patients afflicted with long-haul COVID-19 officially named it, Brady said, and that data mining about the illness has come directly from patients. This has been very important to understanding the impact.  

Medinger, an athlete who was training for the London marathon, contracted COVID-19 and found though most people were recovering fairly quickly, he was four weeks in and wasn’t getting any better. After experiencing a particular feeling in his chest and throat, he put out a film on YouTube about what was happening and suddenly found a huge audience.

“I suddenly found myself in this position of having an engaged, motivated audience that wanted to understand what was going on with them,” he said, adding he used that audience to collect data. “I found that 22 percent of long-haulers were testing positive for antibodies.”

Patterson said in the spring 2020, he was finishing up three trials on acute COVID-19 and  he found patients were better, out of the hospital, but by no means of the imagination was their immune system close to normal.

They realized the immune systems of these patients were “really messed up” so they put together a cohort of long-haulers, compared it to moderate and acute COVID-19, and found that by machine intelligence it was a different disease. Long COVID is a separate entity from acute COVID, he said.

Horowitz said a lot of his Lyme disease patients also come down with long-haul COVID-19. They have autoimmune markers he said, but the difference he saw early on was that his patients would have chronic fatigue and muscular skeleton presentation that would get worse.

“All the things I’ve done for Lyme over the years has helped me figure out the path to COVID," he said. 

Brady pointed to a study that patients with long-haul COVID-19 experience reduced aerobic capacity, high blood oxygen levels at the moment of peak exertion, increased oxygen saturation found in venous blood, hyperventilation, and significantly reduced left-side filling pressure. Brady said, what is happening in muscle metabolism is akin to that seen in heart failure. The whole muscle metabolism was just a mess, he said.

Ivermectin was discussed as a treatment for COVID-19. Patterson said his team tried ivermectin, but he doesn’t think it works as a solo agent. He said the recommended doses are way too high and people are having side effects.

“I think it’s a good immune modulator, but the jury is still out for me,” he said. Patterson said he is also very cautious about in vitro data as it’s a nice place to start to screen candidates but does not convert to efficacy.

Panelists also talked about glutathione, quercetin, resveratrol, fluvoxamine, as well as antihistamines as immune moderators for long-haul COVID-19. Horowitz was not surprised antihistamines were being used. Medinger said he notices immediately when there's a delay in taking his regular antihistamines, “I depend on them to get through,” he said.

Brady said that long-haul COVID-19 is pitting patients against doctors, and that patients are not feeling like they are being taken seriously.

“Unfortunately, a lot of Americans are going overseas for various treatments," he said, "and you don’t know the quality of some of these places." 

Editor's note: This article is part of Integrative Practitioner's live coverage of the 2022 Integrative Healthcare Symposium at the Hilton Midtown in New York City. Click here to catch up on the live coverage.